The COVID SEP ended in most states. There is a relatively new special enrollment period that allows people with household income up to 150% of the poverty level to enroll in coverage year-round, for as long as the enhanced subsidies remain in place (so at least through the end of 2025, and possibly longer if Congress grants another extension). So the Consolidated Appropriations Act, 2023 does require states to use the U.S. Post Offices change of address database and/or state Department of Health and Human Services data to ensure that the state has updated contact information for people whose coverage eligibility is being redetermined. According to a KFF survey conducted in January 2022, states were taking a variety of steps to prepare for the end of the continuous enrollment provision (Figure 4). Healthcare Dive reports that the majority of people with Medicaid do not know that their coverage could end when the public health emergency ends. During the COVID-19 national public health emergency that began in March 2020, states have been leaving people on Medicaid. Medicaid eligibility redeterminations will resume in 2023. Find out how much financial help you may qualify for. Enrollees who have moved may not receive important renewal and other notices, especially if they have not updated their contact information with the state Medicaid agency. These projected coverage losses are consistent with, though a bit lower than, estimates from the Department of Health and Human Services (HHS) suggesting that as many as 15 million people will be disenrolled, including 6.8 million who will likely still be eligible. Please contact Medicare.gov or 1800 MEDICARE to get information on all of your options. (Prior to the pandemic, states had to recheck each enrollees eligibility at least once per year, and disenroll people who were no longer eligible. After three years of regulatory flexibility in many areas of healthcare delivery, implications of the PHE unwinding for patients, nurses, and communities will be significant. These enhanced reporting metrics require states to report the total number of individuals renewed and those renewed on an ex parte basis, break out Medicaid terminations for childrens coverage and pregnancy-related coverage, report the number of individuals whose coverage was terminated for procedural reasons, including breakouts for childrens coverage and pregnancy-related coverage, and report total call center volume, average wait time, and average abandonment rate. This additional match will be slowly wound down through 2023 and the federal match will be returned to what it had been prior to the PHE in January 2024. Medicaid and CHIP Services Information for People Receiving Services English Espaol In response to the COVID-19 pandemic, the federal government declared a public health emergency (PHE) and passed a law that allowed you to automatically keep your Medicaid coverage (continuous Medicaid). Starting April 1, 2023, states can resume Medicaid disenrollments. The end of the PHE could also lead to the resumption of student loan payments that were deferred due to the pandemic. Based on illustrative scenariosa 5% decline in total enrollment and a 13% decline in enrollmentKFF estimates that between 5.3 million and 14.2 million people will lose Medicaid coverage during the 12-month unwinding period (Figure 2). The COVID-19 pandemic cast a spotlight on the importance of the various safety net systems that the U.S. has in place. You may have to submit documentation to the state to prove your ongoing eligibility, so pay close attention to any requests for information that you receive. Those participating in the negotiations caution that some details remain unresolved and the deal could still fall apart as lawmakers and staff rush to finalize the bill language, but interest from both sides is mounting. Medicaid enrollees should pay close attention to redetermination notices that they may receive once normal eligibility redeterminations resume. There are millions of people who became eligible for Medicaid at some point since March 2020, and are still enrolled in Medicaid even though they would not be determined eligible if they were to apply today. Filling the need for trusted information on national health issues, Jennifer Tolbert and | T p{YWY4,;U|p9 Read about your data and privacy. By preventing states from disenrolling people from coverage, the continuous enrollment provision has helped to preserve coverage during the pandemic. The Public Health Emergency and Extended Medicaid Coverage | Unwind Issues Impacting Miami-Dade County 11/16/2022 This webinar, sponsored by the South Florida Enrollment Coalition, discusses the continuous Medicaid coverage that has been part of the Public Health Emergency, the expected impact on Miami-Dade County residents currently on Medicaid, and what advocates should know in preparation . 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision, 10 Things to Know About Medicaid Managed Care, FAQs on Health Spending, the Federal Budget, and Budget Enforcement Tools, Health Insurer Financial Performance in 2021. during which you can transition to Medicare without any late enrollment penalties. But if the answer is no, be prepared for a coverage termination notice at some point after the end of March 2023. CMS is ending the requirement that the supervising clinician be immediately available at the end of the calendar year where the PHE ends. Free or nearly free coverage will be available in the marketplace for people eligible for this special enrollment period (this is a result of the American Rescue Plans subsidy enhancements). However, the Administrations superseding debt forgiveness program is still pending in the courts. Get an email every time we post. Two key public health reauthorizationsthe Pandemic and All-Hazards Preparedness Act (PAHPA) and the President's Emergency Plan for AIDS Relief (PEPFAR)are due for renewal in 2023. By law, public health emergencies are declared in 90-day increments. So, there is some ambiguity as to when payments will be required to resume. For system readiness reporting, states are required to demonstrate that their eligibility systems for processing renewals are functioning correctly, particularly since states have not been conducting normal renewals while the continuous enrollment provision has been in effect. A majority of states also indicated they were taking steps to update enrollee contact information and were planning to follow up with enrollees before terminating coverage. Louise Norrisis anindividual health insurancebroker who has been writing about health insurance and health reform since 2006. If your state notifies you that youre no longer eligible for Medicaid and you believe that you are still eligible, you can appeal the states decision. That is now expected to happen in May 2023. Both . This will be the case, for example, for someone who was enrolled under Medicaid expansion guidelines (which only apply through age 64) and has turned 65 during the PHE. It can be allowed to expire at the end of the 90-day period or terminated early if deemed appropriate. Heres what enrollees need to know. If you no longer meet your states Medicaid eligibility guidelines, its a good idea to understand what your options will be when your state begins disenrolling people who are no longer eligible. It also provides states more time to prepare for new rules that will put millions in jeopardy of losing their health insurance, something state Medicaid directors have been demanding from legislators. What are your coverage options if youre disenrolled from Medicaid? Helping millions of Americans since 1994. 528 0 obj
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[Editors Note: Read the latest on the public health emergency Medicaid continuous coverage protectionhere.]. But the overall pace of Medicaid eligibility redeterminations and disenrollments will vary considerably from one state to another. But that was an uncertain and ever-changing date, as the PHE has continued to be extended. The purpose of this bulletin is to inform providers that the federal public health emergency (PHE) was extended on January 14, 2022, and will now last until April 16, 2022. Contact Us, 2023 Center for Children & Families (CCF) of the Georgetown University Health Policy Institute, McCourt School of Public Policy, Georgetown University | 600 New Jersey Ave. NW | Washington, DC 20001 | 202.784.3138, Georgetown Center for Children and Families Homepage, Percent of Children Covered by Medicaid/CHIP by Congressional District, 2018, Percent of Adults Covered by Medicaid/CHIP by Congressional District, 2018, renewed the COVID-related public health emergency. HHS says it plans to extend Covid-19 public health emergency - POLITICO Health Care HHS says it plans to extend Covid-19 public health emergency An extension would ensure expanded. (As well discuss in a moment, the Consolidated Appropriations Act, 2023, has changed this rule). The Biden administration has extended the public health emergency (PHE) for 90 days, from October 18, 2021 through January 16, 2022. However, there will also be current enrollees who are determined to be no longer be eligible for Medicaid, but who may be eligible for ACA marketplace or other coverage. The Biden administration appears headed toward extending the COVID-19 public health emergency for another three months, allowing special powers and programs to continue past the midterm election. In addition, Executive Order 84 allowed for certain additional state flexibilities under a new, temporary state PHE. Written by Diane Archer. The Administration's plan is to end the COVID-19 public health emergency (PHE) on May 11, 2023. The COVID public health emergency (PHE) is expected to be extended again in January 2023, but the omnibus bill de-links the resumption of Medicaid eligibility redeterminations from the PHE, and allows states to start processing eligibility determinations as of April 1, 2023. HHS Secretary Xavier Becerra announced the decision Wednesday via a declaration. And if youve moved or your contact information has changed since you first enrolled in Medicaid, make sure the state has your current contact information on file. This 152-day extension then ends on October 9. The GOP-led Senate passed the proposal in the 2022 session, but it was killed in the House. For the most up-to-date news and . Check out this important update From Centers for Medicare & Medicaid Services "Update: On Thursday, December 29, 2022, President Biden signed into law H.R. In the Calendar Year (CY) 2022 Home Health Prospective Payment System (PPS) final rule, CMS snuck . As a result . 541 0 obj
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